Physical and mental health correlates of perceived financial exploitation in older adults: Preliminary findings from the Finance, Cognition, and Health in Elders Study (FINCHES)

Factors Associated With Elder Abuse According to the Levels of Social Determinants in Brazil

OBJECTIVE

The aim of this study was to analyze the factors associated with elder abuse according to the levels of social determinants.

METHODOLOGY

This is a quantitative and multicentric study, with a cross-sectional cut. It was developed in two teaching hospitals in Paraíba, Brazil, with 323 older adults, from July 2019 to February 2020. Data were collected using the Hwalek-Sengstock Elder Abuse Screening Test and Conflict Tactics Scale-1 and then analyzed using descriptive and inferential statistics.

RESULTS

There was a significant association between risk for violence and female gender (p = 0.004), residing with grandchildren (p = 0.025), and having four or more comorbidities (p < 0.00). Physical violence was associated with income (p = 0.048). A positive correlation was observed between the number of comorbidities and the risk for violence score (p < 0.001), psychological violence (p = 0.004), and physical violence (p = 0.005). The probability of presenting a risk to violence increased by 2.08 times for women, 1.03 times for those who were illiterate, and 7.03 times for those with four or more comorbidities.

CONCLUSION

The social determinants of health that integrate the macrosystem, such as income and number of comorbidities, correlate with situations of violence.

Lower entorhinal cortex thickness is associated with greater financial exploitation vulnerability in cognitively unimpaired older adults

Research suggests that increased financial exploitation vulnerability due to declining decision making may be an early behavioral manifestation of brain changes occurring in preclinical Alzheimer's disease. One of the earliest documented brain changes during the preclinical phase is neurodegeneration in the entorhinal cortex. The objective of the current study was to examine the association between a measure of financial exploitation vulnerability and thickness in the entorhinal cortex in 97 cognitively unimpaired older adults. We also investigated financial exploitation vulnerability associations with frontal regions typically associated with decision making (e.g. dorsolateral and ventromedial prefrontal cortices), and additionally examined the interactive effect of age and cortical thickness on financial exploitation vulnerability. Results showed that greater financial exploitation vulnerability was associated with significantly lower entorhinal cortex thickness. There was a significant interaction between age and entorhinal cortex thickness on financial exploitation vulnerability, whereby lower entorhinal cortex thickness was associated with greater financial exploitation vulnerability in older participants. When the group was divided by age using a median split (70+ and <70 years old), lower entorhinal cortex thickness was associated with greater vulnerability only in the older group. Collectively, these findings suggest that financial exploitation vulnerability may serve as a behavioral manifestation of entorhinal cortex thinning, a phenomenon observed in suboptimal brain aging and preclinical Alzheimer's disease.

Perceived Financial Vulnerability, Wealth, and Wealth Change: The Health and Retirement Study

OBJECTIVES

The 6-item Perceived Financial Vulnerability (PFV) scale assesses awareness and psychological vulnerability regarding finances. Prior findings using the Health and Retirement Study (HRS) identified significant associations of PFV with wealth, demographics, and health status. This study examines the relationship between wealth, changes in wealth, and PFV.

METHODS

Data from HRS respondents were analyzed (N = 1,056). Total assets at baseline (2016) and changes in total assets over two waves (2016 to 2018) were stratified into deciles and used as primary predictors of PFV in 2018. Multiple linear regression models examined the influence of demographics, wealth change (linearly and curvilinearly), and baseline wealth on PFV.

RESULTS

Wealth change and baseline wealth were associated with PFV. When controlled for baseline wealth, wealth loss linearly predicted increased PFV.

CONCLUSIONS

These findings support the utility of the PFV. Findings underscore the importance of integrating multifaceted financial and demographic information when conceptualizing subjective financial welfare.

CLINICAL IMPLICATIONS

Financial wellbeing is crucial in older clients and should be assessed over time. The 6-item PFV effectively evaluates contextual aspects of financial decision-making across socioeconomic statuses, making it valuable for clinical assessments.

Phishing vulnerability compounded by older age, apolipoprotein E e4 genotype, and lower cognition

With technological advancements, financial exploitation tactics have expanded into the online realm. Older adults may be particularly susceptible to online scams due to age- and Alzheimer's disease-related changes in cognition. In this study, 182 adults ranging from 18 to 90 years underwent cognitive assessment, genotyping for apolipoprotein E e4 (APOE4), and completed the lab-based Short Phishing Email Suspicion Test (S-PEST) as well as the real-life PHishing Internet Task (PHIT). Across both paradigms, older age predicted heightened susceptibility to phishing, with this enhanced susceptibility pronounced among older APOE4 allele carriers with lower working memory. Additionally, performance in both phishing tasks was correlated in that reduced ability to discriminate between phishing and safe emails in S-PEST predicted greater phishing susceptibility in PHIT. The current study identifies older age, APOE4, and lower cognition as risk factors for phishing vulnerability and introduces S-PEST as an easy-to-administer, ecologically valid tool for assessing phishing susceptibility.

Scam Susceptibility: Thoughts on How to Initially Approach and Manage Patients in a Geriatric Psychiatry Setting

Recent studies have demonstrated that older adults are more vulnerable to scams because of social isolation, economic affluence, mental disorders, struggles with technology, and cognitive impairments. In this report, we present the case of a 73-year-old man who fell victim to multiple scams over 8 years, leading to a loss of more than $100,000. We also discuss approaches to managing such patients in the outpatient setting. Susceptibility to scams is considered an increasing threat to the well-being of aging societies. The complexity of the problem and the scarcity of available studies make the management of such cases challenging for clinicians.

Trust and betrayal in older adult financial exploitation

OBJECTIVES

Although the knowledge base regarding the financial exploitation of older adults is expanding, work to understand the subpopulations of older adult financial exploitation victims and their experiences is greatly needed. This study uses betrayal trauma theory (BTT) as the foundation for conceptualizing the harm that arises from elder family financial exploitation.

METHODS

The study uses a cross-sectional design to investigate group differences among a total sample of 95 community-dwelling older adults, 32 of the participants (33.7%) were older adult victims of family financial exploitation and the remaining 63 (66.3%) were victims of financial exploitation perpetrated by strangers.

RESULTS

The group of older adults who were victims of elder family financial exploitation had significantly lower functional ability scores, higher stress and financial exploitation vulnerability scores and lost more money on average than those victimized by strangers.

CONCLUSION

The present study provides support that BTT provides a valuable framework for understanding why older adult family financial exploitation victims are more vulnerable than victims of exploitation committed by strangers. Attention to this subgroup of financially exploited older adults will provide improved understanding of the unique challenges these victims face and inform prevention and intervention services.

Financial exploitation and mental health among Holocaust survivors: the moderating role of posttraumatic symptoms

OBJECTIVES

We examined whether anxiety and depressive symptoms associated with self-reported history of financial exploitation (FE) are more pronounced among Holocaust survivors (HS), especially those with high-level posttraumatic stress disorder (PTSD) symptoms.

DESIGN

Self-report questionnaires completed online via Qualtrics.

SETTING

An online-based survey conducted in Israel.

PARTICIPANTS

A community-based cohort of 137 Israeli older adults born prior to 1945 were included in the study sample. HS (n = 61) were participants who reported living in a European country occupied or dominated by Nazi or pro-Nazi regimes between 1939 and 1945. Groups were further subdivided into survivors with low or high levels of PTSD symptoms (≥31 on the PTSD Checklist; PCL-5).

MEASUREMENTS

Questionnaires assessed FE history, posttraumatic symptoms (PCL-5), depressive symptoms (PHQ-9), and anxiety (GAD-7). Age, education, self-rated health, and non-Holocaust lifetime adversity were also measured and included as covariates.

RESULTS

Hierarchical linear regression models revealed that relationships between FE and depressive and anxiety symptoms were significant only among survivors (p = 0.005 and p = 0.008, respectively). The interaction between PTSD symptom level group and FE was also significant for both depressive (p = 0.007) and anxiety (p = 0.012) symptoms, such that survivors with PTSD who reported FE had significantly greater symptoms of depression and anxiety compared to all other groups.

CONCLUSIONS

Findings suggest that the experience of FE may be particularly impactful among survivors who continue to struggle with posttraumatic symptoms related to the Holocaust. Future studies may consider examining whether findings are relevant to other groups with PTSD.

The Cognitive Correlates of Financial Literacy in Older Adults

OBJECTIVES

This study examined the cognitive correlates of financial literacy using a comprehensive neuropsychological battery, and whether education modifies the relationship between cognition and financial literacy.

METHODS

Sixty-six participants completed sociodemographic questionnaires, an assessment of financial literacy, and a neuropsychological assessment. Multiple linear regression models that controlled for age, sex, and education examined the main effects of cognitive measures that showed a significant bivariate association with financial literacy.

RESULTS

After correcting for multiple comparisons, the Crystallized Composite score (p = .002) and the Picture Vocabulary test (p = .002) from the NIH Toolbox, and the Multilingual Naming Test (p > .001) from the Uniform Data Set 3 were associated with financial literacy. Contrary to our hypothesis, education did not interact with cognitive measures when considering financial literacy scores.

CONCLUSIONS

Findings suggest that vocabulary knowledge and semantic memory may play an important role in financial literacy in older age.

CLINICAL IMPLICATIONS

Assessing vocabulary knowledge and semantic processes may help to identify older adults with lower financial literacy skills. Additionally, financial literacy interventions may consider targeting individuals with lower vocabulary knowledge and semantic processing skills.

Interpersonal dysfunction predicts subsequent financial exploitation vulnerability in a sample of adults over 50: a prospective observational study

OBJECTIVES

The goal of this study was to test whether interpersonal dysfunction, characterized by loneliness and/or dissatisfaction with relationships, is an imminent predictor of financial exploitation vulnerability (FEV) among adults age 50+ within a 6-month observation period. This study also tests whether FEV prospectively predicts interpersonal dysfunction.

METHODS

Twenty-six adults aged 50 or older completed a study involving baseline data collection and 13 follow-ups over 6 months. Linear mixed models were used for primary analyses.

RESULTS

After adjustment for demographic, psychological and cognitive covariates, there were between-person effects of FEV and interpersonal dysfunction across follow-ups, suggesting that those with generally higher interpersonal dysfunction compared to other participants also reported greater FEV (B(SE) = 1.09(.33), p = .003). There was a within-person effect (B(SE) = .08(.03), p = .007) of elevated interpersonal dysfunction predicting greater FEV two weeks later across all follow-ups. Within-person effect of FEV was not predictive of interpersonal dysfunction (B(SE) = .25(.15), p = .10). There was also a significant effect of age (B(SE) = -.06(.02), p = .007), such that older individuals had lower FEV throughout follow-ups.

CONCLUSION

Among adults age 50+, individuals with higher interpersonal dysfunction relative to others in the study reported greater FEV throughout the 6-month observation period. Increased loneliness and social dissatisfaction, relative to one's average level, predicts subsequent increases in FEV, and may be an imminent risk factor for exploitation.

Prevalence of depression and its association with quality of life in patients after pacemaker implantation during the COVID-19 pandemic: A network analysis

Background

This study was designed to investigate the prevalence and predictors of depression in patients after pacemaker implantation during the COVID-19 pandemic in addition to identifying specific depressive symptoms associated with quality of life (QOL) using network analysis (NA).

Methods

This cross-sectional, observational study was conducted in China between July 1, 2021, and May 17, 2022. Descriptive analysis was used to calculate depression prevalence. Univariate analyses were used to compare differences in demographic and clinical characteristics between depressed and non-depressed patients following pacemaker implantation. Binary logistic regression analysis was used to assess factors independently associated with depression. Network analysis “expected influence,” and flow function indexes were used to identify symptoms central to the depression network of the sample and depressive symptoms that were directly associated with QOL, respectively. Network stability was examined using a case-dropping bootstrap procedure.

Results

In total, 206 patients implanted with a pacemaker met the study entry criteria and completed the assessment. The overall prevalence of depression (PHQ-9 total score ≥ 5) was 39.92% [95% confidence interval (CI) = 29.37−42.47%]. A binary logistic regression analysis revealed that patients with depression were more likely to report a poor health status (p = 0.031), severe anxiety symptoms (p &lt; 0.001), and fatigue (p &lt; 0.001). In the network model for depression, “Sad mood,” “Poor Energy,” and “Guilt” were the most influential symptoms. “Fatigue” had the strongest negative association with QOL, followed by “Sad mood” and “Appetite”.

Conclusion

Depression is common among patients having undergone pacemaker implantation during the COVID-19 pandemic. Anxiety, central symptoms of depression (i.e., “Sad mood”, “Poor Energy”, and “Guilt”) and depressive symptoms linked to QOL (i.e., “Sad mood”, “Appetite”, and “Fatigue”) identified in this study are promising targets for interventions and preventive measures for depression in patients who have undergone pacemaker implants.

The association between experiences of being defrauded and depressive symptoms of middle-aged and elderly people: a cross-sectional study in China

OBJECTIVES

This study assessed the correlation between middle-aged and elderly fraud victimhood's experiences of being defrauded (EOBD) and depressive symptoms.

STUDY DESIGN

This was a prospective study.

METHODS

Data from China Health and Retirement Longitudinal Study 2018 (N = 15,322, mean age = 60.80 years) were used. Logistic regression models were used to identify the association between EOBD and depressive symptoms. Independent analyses were used to examine the association between different types of the fraud and depressive symptoms.

RESULTS

Among the middle-aged and elderly people, 9.37% of them have EOBD, and it was significantly associated with depressive symptoms. Among those with EOBD, fundraising fraud (3.72%) and fraudulent pyramid scheme and sales fraud (22.4%) were significantly associated with depressive symptoms, whereas telecommunication fraud (73.88%) had a limited role in inducing depressive symptoms in victimhood.

CONCLUSION

This study suggested that the government should make further efforts to prevent fraud, pay more attention to the mental health of the middle-aged and elderly victimhood, and provide timely psychological assistance to reduce the secondary harm caused by fraud.

Reducing older people's risk of fraud victimization through an anti-scam board game

This study adopted an experimental design to evaluate the effectiveness of an anti-scam education program for older adults. Participants in the experimental group (n = 55) first participated in an anti-scam board game and then joined another board game featuring local tea restaurants two weeks later, whereas such order was reversed for the control group (n = 54). Compared with the control group, participants in the experimental group reported significant increases in their self-efficacy in fraud prevention and awareness of scam situations, and a significant decrease in perceived susceptibility to scams immediately and two weeks after the intervention, demonstrating the immediate and the short-term effects of the anti-scam education program in reducing fraud victimization risk of older adults.

Bedtime and the Budget: Longitudinal, Actor-Partner Connections between Sleep Quality and Financial Management Behaviors in Newlywed Couples

Research from the American Psychological Association suggests that approximately 67% of U.S. adults are getting more or less sleep than desired, and over 80% of U.S. adults ages 18-43 are stressed about finances. Cross-sectional evidence suggests that there may be a connection between the two. That is, some cross-sectional research suggests a contemporaneous association between sleep quality and finances. Using two waves of newlywed dyadic data (N = 1497 couples), we estimated a longitudinal structural equation model to test actor-partner associations between husbands' and wives' sleep quality and financial management behaviors. In these associations, we examined husbands' and wives' marital satisfaction as potential mediating variables. We found that both husbands' and wives' sleep quality longitudinally predicted their own and their partner's financial management behaviors. Additionally, husbands' and wives' sleep quality-through wives' marital satisfaction-indirectly and longitudinally predicted wives' financial management behaviors. As financial practitioners encourage newlywed couples to consistently experience quality sleep, their financial management behaviors may benefit. We suggest that for newlywed couples, both partners' bedtime may be longitudinally connected to both partners' management of their budget.

Self-reported fraud victimization and objectively measured blood pressure: Sex differences in post-fraud cardiovascular health

BACKGROUND

Over 5 million older Americans are victims of financial exploitation, schemes, and/or scams per year. Such victimization is associated with increased hospitalizations, admittance to skilled nursing facilities, and lower 5-year all-cause mortality survival rates. Despite this, associations with medical comorbidities like elevated blood pressure (BP) have not been examined.

METHODS

We investigated the association of self-reported fraud victimization (presence/absence) with objectively measured BP metrics leveraging cross-sectional and longitudinal data from over 1200 non-demented adults (75% female; age ~81 years) from the Rush Memory and Aging Project. We first examined cross-sectional associations between baseline fraud victimization and BP, then used longitudinal data to test the hypothesis that fraud victimization is associated with increases in BP after incident fraud. During up to 11 years of annual observation, participants were queried for fraud victimization and underwent serial BP measurements to calculate per visit averages of systolic and diastolic BP, mean arterial pressure (MAP), and pulse pressure.

RESULTS

Cross-sectional analyses established that fraud victimization at baseline was associated with higher BP values. Next, using longitudinal changepoint analyses, we showed that fraud victimization was associated with elevations in BP among men but not women. Specifically, men who reported incident fraud exhibited increases in all BP metrics post-fraud.

CONCLUSION

Results suggest an important link between fraud victimization and BP, particularly among men. Older men showed significant elevations in BP after incident fraud that, compounded over time, may portend other adverse health outcomes.

Cognitive and neuroimaging correlates of financial exploitation vulnerability in older adults without dementia: Implications for early detection of Alzheimer's disease

Neuropathology characteristic of Alzheimer's disease (AD) begins to accumulate years to decades before cognitive changes are clinically detectable on standard neuropsychological tests. This presents a challenge for early intervention efforts and has spurred research on the identification of behavioral correlates of early neuropathological changes. Recent evidence suggests that financial exploitation vulnerability (FEV) due to impaired decision making may serve as an early behavioral manifestation of AD neuropathology, thereby indicating an increased likelihood for subsequent cognitive decline. An understanding of the underlying mechanisms of FEV is therefore warranted for the identification of individuals at risk for cognitive decline due to AD, and for empowering and protecting older adults vulnerable to financial exploitation. In the current review, we first highlight the devastating consequences of financial exploitation of older adults. We then summarize research on the cognitive, neuroimaging, and neuropathological correlates of FEV in older adults without dementia and propose a theoretical model in which early accumulation of AD pathology manifests as FEV. We conclude with clinical implications and directions for future research.

Increased Financial Altruism is Associated with Alzheimer's Disease Neurocognitive Profile in Older Adults

BACKGROUND

Older age is associated with an increase in altruistic behaviors such as charitable giving. However, few studies have investigated the cognitive correlates of financial altruism in older adults.

OBJECTIVE

This study investigated the cognitive correlates of financial altruism measured using an altruistic choice paradigm in a community-based sample of older adults.

METHODS

In the present study, a sample of older adults (N = 67; M age = 69.21, SD = 11.23; M education years = 15.97, SD = 2.51; 58.2% female; 71.6% Non-Hispanic White) completed a comprehensive neuropsychological assessment and an altruistic choice paradigm in which they made decisions about allocating money between themselves and an anonymous person.

RESULTS

In multiple linear regression analyses that controlled for age, education, and sex, financial altruism was negatively associated with performance on cognitive measures typically sensitive to early Alzheimer's disease (including word list learning and recall, delayed story recall, and animal fluency).

CONCLUSION

Findings of this study point to a negative relationship between financial altruism and cognitive functioning in older adults on measures known to be sensitive to Alzheimer's disease. Findings also point to a potential link between financial exploitation risk and Alzheimer's disease in older age.

The Relationship Between Financial Decision-Making and Financial Exploitation in Older Black Adults

Objectives: This study examined the relationship between contextual measure of financial decision-making and the financial exploitation experiences of older Blacks, and the convergent validity of mental health measures of contextual decision-making items. Methods: This cross-sectional study of 104 older Black adults included 52 cases of confirmed financial exploitation. Participants were matched on age and gender. Bivariate and multivariate analyses were performed to examine these relationships. Results: The contextual measure of financial decision-making was significantly associated with financial exploitation, above and beyond the relationship of demographic measures. Further, there was strong evidence for convergent validity between the contextual measure and mental health measures. Discussion: Results underscore the significant relationship of the contextual factors involved in financial decision-making and financial exploitation. This study provides a conceptually driven approach to understanding the experiences of older Black adult victims of financial exploitation.

Contact-Fraud Victimization among Urban Seniors: An Analysis of Multilevel Influencing Factors

Fraud crime against seniors has become a serious social problem both at home and abroad. While most of the relevant research focuses on non-contact fraud against seniors, a few studies attend to contact fraud targeted at seniors. By constructing a theoretical framework of “environment–activity–fraud victimization” based on the integration of multiple theories, this study conducts a multilevel logit analysis of contact-fraud victimization among urban seniors in the downtown area of Guangzhou at the individual and neighborhood levels. The results show that contact-fraud victimization among urban seniors is influenced by individual-level factors and neighborhood-level factors, and that individual-level factors play a more significant role. More specifically, seniors with higher education levels and lower levels of self-control are more likely to experience contact-fraud victimization, while seniors who are older and healthier, and have higher household income are significantly less likely to experience contact-fraud victimization. Further, higher levels of collective efficacy and better living environments in the neighborhood significantly reduce the probability of contact-fraud victimization among urban seniors, while the percentage of the migrant population, the percentage of the aging population, and developed traffic environments significantly increase the probability of seniors experiencing contact fraud. This study confirms the feasibility of examining contact-fraud victimization among urban seniors based on the integration of theories, and enriches the research results of crime geography in terms of contact-fraud victimization among urban seniors.

Financial fragility and scam susceptibility in community dwelling older adults

We tested the hypothesis that financial fragility is associated with higher scam susceptibility in older adults without dementia. Data came from nearly 900 community-dwelling participants from two ongoing cohort studies of aging. Financial fragility was determined by assessing an individual's ability to access $2,000 within a month for an unexpected expense. Scam susceptibility was assessed via a 5-item instrument that measures perceptions and behaviors that predispose older adults to financial fraud and scams. On average, participants were 82 years of age. Nearly 10% reported financial fragility. Financial fragility was higher in Blacks and among those with fewer years of education, lower income, lower global cognition, lower literacy, and poorer financial decision-making. Regression analysis revealed that financially fragile older adults were more susceptible to scams. These data suggest that targeted efforts to reduce financial fragility and improve literacy and cognitive health are needed to prevent elder exploitation among diverse populations.

A Scoping Review and Conceptual Framework Examining the Role of Sleep Disturbance in Financial Exploitation in Older Adults

Sleep disturbances and financial exploitation have both been linked to impaired cognitive ability, loneliness, and depressed mood in older adults, suggesting a potential role of sleep disturbances in increasing vulnerability to financial exploitation. We sought to identify evidence linking sleep disturbances to financial exploitation. We conducted a systematic search of MEDLINE, PubMed Central, and National Center for Biotechnology Information Bookshelf for relevant published articles on sleep and financial exploitation. Three studies examining both sleep and financial exploitation were identified. None of the studies explored sleep disturbances as a cause of financial exploitation. More work needs to be done to examine the role of sleep disturbances in financial exploitation. We propose a conceptual framework for identifying possible associations among sleep disturbance, biopsychosocial, and decision-related situational factors to guide further exploration of relationships between sleep and financial exploitation.

The Impact of Financial Coaching on Older Adult Victims of Financial Exploitation: A Quasi-Experimental Research Study

The financial exploitation (FE) of older adults affects not only victims' finances, but also their health. This preliminary study investigated the impacts of a financial coaching program on the financial, neurocognitive, physical, and emotional health of older adult victims of FE. Twenty older adults residing in a large urban area who had experienced FE were compared at baseline and follow-up with a group of 20 older adult of the same area who were making important financial decisions, but had not experienced FE and did not receive the intervention. At baseline, both groups were similar on demographic variables, but participants who had experienced FE had more health problems, poorer memory and executive functioning, less social support, and greater stress than the comparison group. Six months after financial coaching ended, program participants had significantly less anxiety. Overall, older adult victims of FE showed no significant declines and, in fact, showed some improvement.

Impacts of mistreatment on the psychological and physical health of older adults living in sheltered homes

OBJECTIVES

To assess the impact of the mistreatment on psychological and physical health among older adults living in sheltered homes.

METHODS

This cross-sectional study included 446 older adults living in 43 sheltered homes. The psychological effects questions screened for suicidal ideation, depression, anxiety, and sleep problems. The physical health effects questions assessed perceived physical health status and healthcare resource utilization.

RESULTS

All subtypes of mistreatment of older adults were associated with increased prevalence rates of anxiety symptoms, depressive symptoms, and sleep problems. Perceived poor physical health is common among older mistreated adults; it was self-reported by 74% who experienced physical mistreatment and 49% who experienced other types of mistreatment. Increased healthcare utilization was higher among older adults who experienced mistreatment.

DISCUSSION

Mistreatment of older adults living in sheltered homes is associated with negative impacts on physical and psychological health, as well as increased healthcare utilization compared to those who are not mistreated.

Susceptibility to Scams in Older Black and White Adults

Previous reports on racial differences in scam susceptibility have yielded mixed findings, and few studies have examined reasons for any observed race differences. Older Black and White participants without dementia (N = 592) from the Minority Aging Research Study and the Rush Memory and Aging Project who completed a susceptibility to scam questionnaire and other measures were matched according to age, education, sex, and global cognition using Mahalanobis distance. In adjusted models, older Black adults were less susceptible to scams than older White adults (Beta = -0.2496, SE = 0.0649, p = 0.0001). Contextual factors did not mediate and affective factors did not moderate this association. Analyses of specific items revealed Black adults had greater knowledge of scam targeting of older adults and were less likely to pick up the phone for unidentified callers. Older Black adults are less susceptible to scams than demographically-matched older White adults, although the reasons remain unknown.

Perceived Types, Causes, and Consequences of Financial Exploitation: Narratives From Older Adults

OBJECTIVES

The goal of this study was to investigate the perception of financial exploitation and its causes and consequences by older adults who have firsthand experience of being exploited.

METHOD

Thirty-one cognitively healthy older adult participants aged 50 or older were drawn from the Finance, Cognition, and Health in Elders Study. In-depth, one-on-one interviews were conducted. Interview transcripts were analyzed using an iterative, data-driven, thematic coding scheme and emergent themes were summarized.

RESULTS

Categories of financial exploitation included (a) investment fraud, (b) wage theft/money owed, (c) consumer fraud, (d) imposter schemes, and (e) manipulation by a trusted person. Themes emerged around perceived causes: (a) element of trust, (b) promise of financial security, (c) lack of experience or awareness, (d) decision-making, and (e) interpersonal dynamics. Perceived consequences included negative and positive impacts around (a) finances, (b) financial/consumer behaviors (c) relationships and trust, (d) emotional impact, and (e) future outlook.

DISCUSSION

These narratives provide important insights into perceived financial exploitation experiences.

Correlates of Susceptibility to Scams in Community-Dwelling Older Black Adults

INTRODUCTION

Evidence suggests that older Black adults are frequent victims of financial fraud and exploitation. This study aims to identify the factors associated with scam susceptibility in older Black adults.

METHODS

Participants were 383 older Black adults living in the Chicago metropolitan area (mean age = 78 years and 82% female). A scam susceptibility measure assessed perceptions and behaviors that predispose older adults to fraud and scams. Categories of age-associated factors, including cognition, physical health, psychosocial factors, personality, and behavioral economics, were measured using uniform systematic assessments. For each category separately, measures associated with scam susceptibility were identified via stepwise variable selection.

RESULTS

Older age was associated with greater scam susceptibility. Further, the analysis revealed a robust association of cognitive health with scam susceptibility, particularly the domains of semantic and working memory. Psychological well-being was associated with susceptibility, as was neuroticism. Behavioral economic measures including financial and health literacy and financial and health decision-making ability were also implicated. In a final model that included all the measures initially retained by variable selection, semantic memory, psychological well-being, and financial and health literacy were independently associated with scam susceptibility. Moreover, the association of age was attenuated and no longer significant after adjusting for these correlates.

DISCUSSION

Age-associated vulnerabilities, rather than age itself, predispose older Black adults to financial fraud and scams. The correlates of scam susceptibility in community-living older Black adults primarily involve cognitive health, psychological, and behavioral economic factors.

Context Matters: Financial, Psychological, and Relationship Insecurity Around Personal Finance Is Associated With Financial Exploitation

BACKGROUND AND OBJECTIVES

Context can influence or overwhelm the intellectual and cognitive aspects of financial decision making but has only recently received increased attention. The construct validity of conceptual subscales from a financial decision-making scale was examined in the context of their relationship to financial exploitation.

RESEARCH DESIGN AND METHODS

Two hundred forty-two community-based participants were recruited into the study. The final sample contained 242 participants. Measures included demographic variables, conceptually derived contextual items, and neurocognitive measures. Seventeen of the 34 contextual items investigated differentiated financially exploited and nonexploited older adults. Combining these 17 contextual items led to the creation of a new scale: the Financial Exploitation Vulnerability Scale (FEVS). Correlational analyses and area under the curve analyses were used to examine the relationship between this new scale of contextual items and other measures and to determine how clinically meaningful the scale was in the current sample.

RESULTS

Contextual items were powerful discriminators between those who were exploited and those who were not. The new scale of contextual items (the FEVS) demonstrated good internal consistency (Cronbach's alpha = 0.82) and a strong area under the curve (receiver operating characteristic = 0.80), thereby indicating good clinical significance and evidence for construct validity.

DISCUSSION AND IMPLICATIONS

We examined the conceptually derived subscales of financial awareness, psychological vulnerability, and relationship strain and how these relate to financial exploitation. Our major finding is that contextual items differentiated between exploited and nonexploited adults, which demonstrate the importance of measuring context in financial decision making and exploitation. A new scale for measuring contextual items was introduced.

Frailty and Perceived Financial Exploitation: Findings from the Finance, Cognition, and Health in Elders Study

Objective: Many older adults who are cognitively intact experience financial exploitation (FE), and the reasons for this are poorly understood. Methods: Data were gathered from 37 older adults (M age = 69.51, M education = 15.89, 62% female) from the Finance, Cognition, and Health in Elders Study (FINCHES). Twenty-four older adults who self-reported FE were demographically-matched according to age, education, race, and MoCA performance to thirteen older adults who denied experiencing FE. Participants completed the Tilburg Frailty Inventory. Results: FE participants reported greater total frailty (t = 2.06, p = .04) when compared to non-FE participants. Post-hoc analyses revealed that FE participants endorsed greater physical frailty (U = 89, p = .03), specifically poorer sensory functioning (hearing and vision). Discussion: Findings suggest frailty is associated with FE in old age and may represent a target for intervention programs for the financial wellbeing of older adults.

Numeracy Skills, Cognitive Reserve, and Psychological Well-Being: What Relationship in Late Adult Lifespan?

BACKGROUND

The capacity of understanding and manipulating numerical stimuli (i.e., numeracy) can impact decision making. This investigation was conducted to examine whether number comprehension and mental calculation predict hedonic (i.e., Scale of Positive and Negative Experience, SPANE) and eudaimonic (i.e., Flourishing Scale) well-being in late adulthood, and whether cognitive reserve (i.e., education, time spent for gardening, and time spent for leisure activities) and non-verbal reasoning predict numeracy skills of old adults. Additionally, the effect of age on numeracy was examined, controlling for the effect of education and cognitive efficiency.

METHODS

One hundred and fifty-eight (i.e., 65-94 years old) community-dwellers completed a battery of tools assessing numeracy, cognitive and metacognitive efficiency, and psychological well-being.

RESULTS

Number comprehension, metacognition, time spent for leisure, and perceived physical health accounted for 23% of the variance in the SPANE condition, whereas metacognition, perceived physical health, time for leisure, and education explained 15% of the variance in the Flourishing condition. Moreover, cognitive reserve assessed in terms of vocabulary and education predicted mental calculation. Finally, aging significantly impacted the mental calculation performance of older participants.

CONCLUSIONS

These findings suggest that numeracy skills can selectively impact the mental health and daily life of older adults.

Functional Connectivity Correlates of Perceived Financial Exploitation in Older Adults

Financial exploitation (FE) in old age is devastating and common; however, the neural correlates of FE are poorly understood. Previous studies of FE in older adults have implicated declines in decision making and social cognition as two risk factors for FE in later life. Here we examined whether functional connectivity among brain regions implicated in decision making and social cognition differed for those with an experience of FE vs. those without. Participants included 16 older adults without cognitive impairment who reported FE (Mean age = 70.5, 62.5% female, Mean education = 16.0 years) and 16 demographically and cognitively matched adults who denied a history of FE (Mean age = 65.1, 37.5% female, Mean education = 15.1 years). Measures of whole-brain resting-state functional connectivity in the hippocampus, insula, and medial frontal cortex were derived for each group. Compared to the non-FE group, FE was associated with greater functional connectivity between the right hippocampus and bilateral temporal regions, and less functional connectivity between the right hippocampus and the right cerebellum and bilateral lingual gyri. The FE group showed less connectivity between the right and left insula and cingulate cortex, and between the right insula and regions of the left lateral temporal gyrus and dorsolateral prefrontal cortex. Finally, the FE group showed greater functional connectivity between the medial frontal cortex and the right lateral temporal gyrus and orbitofrontal cortex, and less functional connectivity with the right pre- and postcentral gyri. Results suggest that perceived FE in old age is associated with whole-brain functional connectivity differences involving the hippocampus, insula, and medial frontal cortex, consistent with models implicating age-associated changes in decision making and social cognition in FE.

Elder mistreatment and psychological distress among U.S. Chinese older adults

OBJECTIVE

This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults.

METHODS

Data were derived from the Population Study of Chinese Elderly (PINE), a study of Chinese older adults aged 60 years and above in the greater Chicago area from 2011-2013. Measurements include elder mistreatment screening tools, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-9. Negative binomial regressions and logistic regressions were performed.

RESULTS

Participants with any mistreatment, psychological mistreatment, physical mistreatment, financial exploitation, and caregiver neglect were more likely to have anxiety symptoms and depressive symptoms. Sexual mistreatment was not associated with symptoms of anxiety and depression.

CONCLUSION AND IMPLICATIONS

The rate of psychological distress differs based on the types of mistreatment among U.S. Chinese older adults. The findings underline the need for public and community awareness and improved education for health care professionals.